| NPI | 1629249529 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: WA MD61209137) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: OH 35.099888) |
| Enumeration Date | 2008-03-19 |
| Last Update Date | 2021-09-13 |